Adaptation to New Dentures and 5 Years of Clinical Use: A Comparison between Complete Denture and Mini-implant Mandibular Overdenture Patients based on Oral Health-Related Quality of Life (OHRQoL) and Orofacial Esthetics

Abstract

Objective of work It is unclear how long patients need to adapt to new dentures. This study assessed adaptation and five years of clinical use, comparing complete denture wearers (CDs) and mini-implant mandibular overdenture wearers opposing a maxillary CD (MDI-OD), based on oral health reported quality of life (OHRQoL) and orofacial esthetics (OES). Material and Methods A total of 36 subjects in the CD group (25 females) and 30 subjects in the MDI group (20 females) completed the 5-year study. All patients received new CDs, but in the MDI-OD group, four mini-implants were inserted interforaminally in the mandible before denture manufacture. Participants filled in the OHIP-EDENT and OES questionnaires one day after dentures’ delivery, on the 3 rd , 8 th , 15 th , 30 th day, and at the 1-, 3- and 5-year follow-up examinations. Statistical analysis comprised descriptive methods, X 2 test, independent t-test, Friedman, and Mann-Whitney test. Results and Conclusions Both groups' adaptation to new dentures was completed within a month. The MDI-OD group had significantly better OHRQoL in all follow-ups except for the 3 rd and 8 th day, probably due to soreness and pain, the reason why the MDI-OD group had limitation in functioning in the first days after new dentures’ delivery. Already after the third year and at the fifth year, OHRQoL worsened (p<0.01) in both groups. However it was significantly more pronounced in the conventional CD wearers (p<0.01) than in the MDI-OD group. Orofacial esthetics was highly scored in both groups. The scores dropped down only after three years, equally in both groups. Keywords OHRQoL, OES, prospective study, complete dentures, mini-implants, adaptation MeSH Terms Complete Dentures; Dental Implants; Quality of Life; Dental Esthetics

Influence of Implant Number on Peri-Implant and Posterior Edentulous Area Strains in Mandibular Overdentures Retained by the New Ti–Zr (Roxolid®) Mini-Implants as Single-Units: In Vitro Study

“…In completely edentulous patients with a reduced alveolar ridge width, the insertion of four mini-dental implants (MDI) for mandibular overdenture (OD) retention and support is the alternative option to the insertion of two standard-sized implants [1][2][3][4][5][6][7][8][9][10][11]. Bone augmentation can be avoided by the insertion of narrow implants, which shortens the duration of treatment, providing a less traumatic surgical protocol [1][2][3][4][5]. Narrow dental implants (NDIs) are divided into three categories depending on their diameters: Category 3 (>3.3 mm-3.5 mm wide), Category 2 (>2.5 mm-<3.3 mm), and Category 1 (≤2.5 mm wide) [12].…”

“…Narrow implants are usually made of Ti90Al6V4 alloy, which has better mechanical properties than pure titanium. The insertion of four MDIs made of Ti90Al6V4 alloy in the mandible has been approved as a successful treatment option for the retention of a mandibular OD in many prospective clinical studies [1][2][3][4][5][6][7][8][9][10][13][14][15].…”

Mini-Implants Retaining Removable Partial Dentures in Subjects without Posterior Teeth: A 5-Year Prospective Study Comparing the Maxilla and the Mandible

“…Mini-implants (MDIs) are one-piece implants and belong to the first and the narrowest category (category 1) of narrow diameter implants (diameter ≤ 2.5 mm) [ 15 ]. The MDIs have been approved as a suitable treatment option for retention of mandibular complete overdentures in subjects with narrow ridges in many follow-up studies [ 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 ]. A recent study recommended MDIs even for the support of crowns or small bridges in the mandibular incisor region [ 24 ].…”

Mandibular Overdenture Supported by Two or Four Unsplinted or Two Splinted Ti-Zr Mini-Implants: In Vitro Study of Peri-Implant and Edentulous Area Strains

“…The four-MDI model represented the reference model, since four single-unit MDIs have been recommended to be placed interforaminally by a manufacturer. Furthermore, the insertion of four MDIs made of Ti90Al6V4 alloy in the intraforaminal region of the mandible, with rubber O-rings in metal housings for OD retention, has been a successful treatment option over a longer period of clinical observation [ 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 ]. The strains in peri-implant bone and the strains from distal edentulous areas under denture saddles are important factors predicting the long-term success of implants which support an OD, especially when knowing that a decrease in implant diameter may increase the stress transferred to the bone–implant interface [ 48 , 49 ].…”

“…Over the last three decades, the placement of four MDIs (Grade 5, Ti90Al6V4 alloy) in the intraforaminal region has proven to be a successful treatment option for the retention and support of mandibular overdentures (ODs). Most clinical studies reported survival rates ranging from 95 to 100%, small amounts of peri-implant bone loss, and increased patients’ satisfaction [ 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 ]. A recent study found out that even only three MDIs can be sufficient for satisfactory five-year clinical outcomes [ 17 ].…”